sue served to good purpose generally throughout surgery,
in the subject at hand more than these should be given
consideration, because we were dealing with biology. It
was not simply a matter of intestinal stasis. We must
remember that the bowel might be matted into one mass
34S
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:ai. Jours
by chronic peritonitis, so that great interference with
peristalsis must exist, and still intestinal toxemia not be
present. Not a few cases of acute intestinal obstruction,
and many of these of Levothroid 100 Mg a chronic type, were not accompanied
by toxemia. The matter of intestinal stasis, an important
one in this connection, was far from being proved, and
it should Levothroid Vs Synthroid always be lemembcred in medicine that the co-
existence of two phenomena did not prove that they stood
in the relation of cause and effect. .Adhesions took place
in the pia mater, pleura, pericardium, and joint cavities only
because of infection with bacteria, and the same was true
of the peritoneal cavity. We did not have to Levothroid Vs Levothyroxine go as far
back as congenital conditions or deep into the theory of
toxemia to account for them, and in his opinion, all ad-
hesions of the peritoneal cavity were directly bacterial in Purchase Levothroid Online
nature. In this connection, it was not necessary to have
ulceration or other pathological conditions of the gut to
permit bacteria to pass outside of its lumen. It had been
proved conclusively that bacteria could pass through a
normal mucous membrane of the intestine, and. prac-
tically, they often did so. The subject was bound up in
the Levothroid 125 Mcg bacteriology of the intestines, and this was further
shown by the fact that the upper part of the small intes-
tine, where there were but few Generic Levothroid bacteria, was practically
free from adhesions. Then, most of the adhesions were
found in those parts of the intestines U'here the veins and
lymphatics emerged, as. for instance, the anterior band
of the colon. Lastly, Levothroid 0.1 Mg his studies had suggested that the
bacteriology of the intestinal canal in adhesion cases was
never normal. There were some ten forms of anaerobes
of the bacilli class alone responsible for adhesions, not to
mention the coccal and aerobic forms. Recently, he had
isolated a new bacterium which was commonly present
in the stools Levoxyl Vs Levothroid of cases where there w-ere marked adhesions
and which, when grown in culture and thrown into the
intestinal canal of dogs, would produce pericolonic adhe-
sions after a few injections. .\s to splanchnoptosis being
responsible for adhesions, he would take different ground
and say that splanchnoptosis was due to intestinal toxemia,
because in his studies of four autopsy cases of splanch-
noptosis he had been able to prove that distinct degenera-
tion of the sympathetic plexuses of the abdomen existed,
this being about the same type of degeneration noted in
some cases Levothroid Synthroid of myoma uteri. Thus he felt that a toxemia
affected the neuromuscular Levothroid Generic structures of the stomach and
intestines, and then the extrinsic nerves: making possible
the production of dilatation of localized or generalized
character. The splanchnics. as was known, were the in-
hibitory influences of the hollow viscera of the abdomen.
Thus, Levothroid 25 Mcg with the toxemia Order Levothroid Online persisting, degeneration took place
in the sympathetic system of the abdomen, and then pro-
lapse ensued by reason of the disturbing effects ^n the
nutrition of the abdomen as a whole. Adhesions might
ensue, as the final result of the to.xemia. plus Is Levothroid Generic bacterial
extravasation.
Dr. W.-VRD J. M.\c\e.\l said that peritoneal adhesion^
were either fibrinous or fibrous. The former were very
temporary, and either disappeared or became organized
into fibrous adhesions. The fibrinous adhesion was pro-
duced by a general peritonitis or by a localized injury to
the peritoneum. It was diflicult to conceive of such local-
ized injury occurring as a result of the penetration of
soluble bacterial Levothroid 88 Mcg toxines through an intact intestinal wall,
and it would seem that the local injury was most fre-
quently caused by a localized infection of the suljserous
tissues or by bacterial invasion of the serosa itself. The
injury to the serous coat brought about a ■ precipitation
of fibrin which served as a weak bond of union to somt
contiguous structure. If this fibrous union organizeii into
fibrous tissue, a typical firm adhesion was the result. It
was the latter type with which the physician and the sur-
geon had to deal. Such a fibrous adhesion was of the
same order as a scar, and it might be impossible to arrive
at any reliable conclusion as to the original etiological
factors by the examination of such a scar. In order to
study the etiology of peritoneal adhesions resort might
best be had to experimental surgery, to ascertain the e.xact
conditions which determined the production of adhesions
and to distinguish them from the circumstances Order Levothroid under
which the form.ation of adhesions did not occur. A series
of careful observations along this line had recently been
reported by Adams in his Hunterian lecture before the
Royal College of Surgeons (Lancet, March 8. T9131. He
had been able to produce both infected and bacteria free
adhesions in the peritoneal cavities of guineapigs and rab-
bits. Noninfective adhesions were induced by destructive
injury to the peritoneum, but with greater certainty by the
introduction of foreign bodies (such as cotton sponges
and Levothyroxine Vs Levothroid drainage tubes) into the peritoneal cavity. Often
these adhesions would subsequently become Synthroid Vs Levothroid infected by
the penetration of bacteria from the lumen of the intes-
tine. Extravasated blood in the peritoneal cavity rarely
caused adhesions unless it had become infected. Infec-
tion of the peritoneum, and especially the introduction
of infected foreign bodies, proved to be a ready method
of causing adhesions. The omentum. Doctor MacNeal
said, was one of the structures which most readily became
adherent to an area of injured iieritoneum. This was in
part due to its wide range of excursion, and in part to
the rapidity of absorption of foreign material by the
lymphatics of the omentum. The movements of the omen-
tum were wholly passive, and depended upon Levothroid 100 Mcg the active
movements of other structures, the most important of
such movements being intestinal peristalsis.
Dr. Robert Colem.xx Kemp Levothroid 75 Mg said that the so called attic
of the abdomen he believed to be of great importance
from a pathological standpoint, and it was Doctor Morris
who first called our attention to the fact that the "spider
web'' adhesions emanating from the diseased gallbladder,
and involving the pylorus or upper duodenum, produced
dilatation of the stomach, and at times even hemorrhage
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